With a succession of pharmacy ministers over the last few years, how do we measure their engagement with the community pharmacy sector? By Saša Janković

As a general election looms, political parties are setting out their stalls, full of promises and ambitions for healthcare and the NHS, with some including insights into possible solutions for the struggling community pharmacy sector.

Liberal Democrat MP Sarah Dyke, for example, recently accused the Conservatives of repeatedly treating community pharmacies as “an afterthought”. She insisted her party is committed to ensuring there is a plan for their long-term survival and a review of the “extraordinary pressures” they are enduring. Dyke said the Liberal Democrats want to see “more training places and incentives to attract people into the [pharmacy] profession” and insisted community pharmacies “need emergency funding from government”.

These observations are, of course, nothing new, but the long list of incumbents who have sat in the role of pharmacy minister over the past five years, makes it hard to track what they have done for the sector.

Leadsom takes the reins

The latest MP to take on the mantle is Dame Andrea Leadsom, appointed on 13 November last year as minister with responsibility for pharmacy in the Department of Health and Social Care (DHSC). She took over the position of Parliamentary Under Secretary of State for Patient Safety and Primary Care after the resignation of Neil O’Brien MP, leaving Leadsom holding a wide-ranging portfolio, including responsibility for primary care, community health, public health and maternity care.

First elected as MP for South Northamptonshire in 2010, one of Leadsom’s first pharmacy-related tasks was to usher in Pharmacy First, alluding to it in a written answer on 16 November 2023 to a question from Stephen Morgan, Shadow Minister for Defence and Transport, who had asked if the Secretary of State for Health and Social Care would make an assessment of the potential merits of increasing the share of NHS funding for general practice to shift care into the community.

Leadsom’s response was that the Delivery Plan For Recovering Access to Primary Care, published on 9 May 2023, “recognised the benefits of moving care closer to home” and supported the vision set out in Dr Claire Fuller’s Stocktake on Next steps For Integrating Primary Care. She added: “This is backed by a major new investment into primary care services, with up to £645 million over two years to expand the services offered by community pharmacies, helping to take the pressure off general practitioners and providing patients with more options for care.”

This was followed a few days later by another written answer from Leadsom noting that negotiations with Community Pharmacy England (CPE) had concluded, with pharmacy contractors “informed by a joint letter from the Department, NHS England and CPE about the detail of Pharmacy First, including the funding of the service [that] will launch on 31 January 2024, subject to the IT underpinning the service being complete”.

This came hot on the heels of an earlier statement from Leadsom in December 2023, saying DHSC was “committed to pursuing legislative changes to level the playing field and enable all community pharmacies to make use of hub and spoke dispensing arrangements”, with the aim of publishing the Department’s response to last year’s hub and spoke consultation “as soon as possible”.

Revolving door

These big-ticket projects could make a substantial difference to community pharmacy, the timing of which could put Leadsom’s tenure in her role in a positive light. This is in contrast to what at times has felt like a revolving door of ministers who have held the post previously – including Will Quince, James Morris, Maria Caulfeld and Jo Churchill since 2019. This has made it difficult for any individual to really make a mark since most of them only experienced one annual cycle of the pharmacy year before they moved on.

In addition, they’ve reported in to six Health Secretaries – Matt Hancock, Sajid Javid, Steve Barclay, Therese Coffey Barclay again, and now Victoria Atkin – in the same period.

Held to account

So what do pharmacy bodies expect of these portfolio holders, and how do they hold them to account? “The last few years have seen a greater frequency of change at ministerial level than we’d normally expect,” says Pharmacists’ Defence Association director Paul Day.

“We know too that there must be a general election at some point in the next 12 months. Nevertheless, however long the current incumbent retains the position, there are lots of important matters on the agenda for the Pharmacy Minister, which they can progress for the benefit of patients, taxpayers, the environment and the profession, including reducing the number of hospital admissions which are linked to issues with prescribed medicines; reducing the environmental impact of medicines; making sure all areas of pharmacy practice are properly funded and resourced, and creating a health system where the clinical skills of pharmacists are being properly utilised in all areas of practice.”

What that means in immediate terms, says Day, is a focus on activities such as the successful implementation of the Pharmacy First service, making sure the consultation on changes to supervision legislation delivers an outcome that allows pharmacists to use their clinical skills to better support patients.

It also means “putting in place measures that mean all those pharmacists who wish to become independent prescribers can do so and that all prescribing pharmacists are able to use that additional competency in a consistent way that benefits patients”, he adds.

CPE chief executive Janet Morrison met with Leadsom soon after she took on her new role to discuss a range of critical topics, including Pharmacy First, funding and pressures, and the role of IT in streamlining communication and referral routes into general practice.

Co-ordinated call to action

CPE also coordinated a letter to Leadsom last month, signed by a collective of 20 MPs from different political parties, calling for urgent action to support community pharmacies by committing to making essential changes. These included “a fair and sustainable core funding model, effective implementation of the Pharmacy First service, and expansion into other clinical service areas”.

“The crucial role of pharmacies in providing essential healthcare services to communities is on the line [but] the financial pressures on pharmacies are extreme, and show no signs of improving,” says Morrison.

“This cannot continue, and we appeal to the new Health Minister to address these, and all of the concerns outlined in this letter. A failure to act to correct some of this will see many more pharmacies closing through 2024.”

RPS manifesto

Ahead of the forthcoming general election, the Royal Pharmaceutical Society (RPS) has published a manifesto calling on general election candidates to show their support to:

• Secure patient access to medicines
  • Support a better connected NHS
  • Enhance accessible prescribing in local communities
  • Maximise health improvement through locally accessible pharmacy teams
  • Support the workforce to deliver patient care
  • Unlock the potential of new advances in medicines
  • Support the UK’s global position in science and research.

“The health service is under continued pressure, striving to maintain patient access to quality care amid workforce shortages, widening health inequalities, and recurring medicines supply issues,” says RPS president Claire Anderson.

“Against this backdrop, the next government will face some key challenges to support patients and the NHS in 2024 and beyond, but there are also opportunities, including growing the number of pharmacist prescribers, delivering care closer to home, and making the most of new advances such as pharmacogenomics. The future of our health service will be a key issue at the next election and I would encourage members to engage with their local candidates to help pharmacy be a part of that debate.”

While the date of the general election is yet to be announced, the RPS is encouraging pharmacy teams to start engaging with their MPs and local prospective parliamentary candidates to show their support for pharmacy. Social media graphics on key issues are available at www.rpharms.com/ manifesto and can be used alongside the hashtag #VotePharmacy.

Finding out what politicians don’t know about community pharmacy is a good place to start. “The NPA has dealt with scores of pharmacy ministers over the years,” says the Association’s director of corporate affairs, Gareth Jones. “It’s vital to help them understand the challenges our sector faces, and also to share with them a positive vision of what we can deliver for patients and the NHS.

“A pharmacy minister who really gets community pharmacy makes a big difference to the quality of conversation within government. Every pharmacy minister brings to the job their own ideas and political principles, but most face the same challenge, which is to deliver tangible improvements to patient care whilst also ensuring value for money. That is something community pharmacy can really help to deliver, with the right level of investment.

“However, there are many others making decisions and influencing policy, from the Health Secretary to Treasury Ministers and permanent officials at all levels of government. So, pharmacy ministers can make a difference, but not on their own.”